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R320 – Non-autologous or prosthetic implant to nose (without septorhinoplasty)

OHIP Respiratory Surgical Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits

This is a surgical procedure for a non-autologous or prosthetic implant to the nose. The fee includes pre-operative and post-operative care as outlined in the Surgical Preamble (). As per the Surgical Preamble (, ), the fee for this service includes pre-operative hospital visits one or two days prior to surgery and post-operative care for up to two weeks, excluding the first and second post-operative visits and the day of discharge visit by the MRP. The major pre-operative assessment where the decision to operate is made is claimed separately.
Pre-authorization required
Written prior authorization by a Ministry of Health medical consultant is required.

The surgical benefit does not include the major pre-operative visit - i.e. the consultation or assessment fee which may be claimed when the decision to operate is made and the operation is scheduled, regardless of the time interval between the major pre-operative visit and surgery.

The hospital or day care admission assessment (consultation, repeat consultation, general or specific assessment or re-assessment, partial assessment) may not be claimed by the surgeon unless it happens to be the major pre-operative visit as defined above.

Pre-operative hospital visits which take place 1 or 2 days prior to surgery are included in the surgical fee.

Post-operative care and visits associated with the procedure for up to two weeks post-operatively, and making arrangements for discharge, to a hospital in-patient are included in the surgical fee, with specific exceptions.

Exceptions to included post-operative care are: the first and second post-operative visits in hospital (payable at the specialty specific subsequent visit fee); and subsequent visit by the Most Responsible Physician (MRP) - day of discharge (C124).

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